Organization
WESTMINSTER VILLAGE WEST LAFAYETTE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY BANE (HEALTH CARE ADMINISTRATOR)
(765) 463-7546
Entity
Organization
Contact information
Practice address
2741 N SALISBURY ST, WEST LAFAYETTE, IN 47906-1431
(765) 463-7546
(765) 463-6846
Mailing address
2741 N SALISBURY ST, WEST LAFAYETTE, IN 47906-1431
(765) 463-7546
(765) 463-6846
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050000931
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000230877
BLUE CROSS PROVIDER #
IN
Enumeration date
09/14/2005
Last updated
08/22/2020
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